CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Texas Health Presbyterian Hospital Rockwall

Billing Code: 99214 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99214
  • Insurance Median: $212
  • Cash Discount Price: $312
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a Office visit, established patient (30-39 min) at Texas Health Presbyterian Hospital Rockwall is $212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $312. Compared to the federal Medicare reimbursement reference rate of $135.6, this hospital’s rate is 1.56x the Medicare baseline. Located in 3150 Horizon Road, Rockwall, TX.
Cash / Self-Pay
$312

Average discount available for prompt cash payment at this facility.

Insurance Median
$212

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$135.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $135.6 (100%)
Cash / Self-Pay: $312 (230%)
Insurance Median: $212 (156%)
Cash: $312 (230% of Medicare)
Ins. Median: $212 (156% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $135.6 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Amerigroup $20 - $139 15%
Blue Cross Blue Shield $20 - $657 15%
Parkland $20 - $139 15%
UnitedHealthcare $20 - $797 15%
Molina $21 - $151 15%
Superior Wellcare $21 - $146 15%
Aetna $85 - $1,020 63%
Fort Worth Firefighters $91 - $888 67%
City Of Fort Worth $97 - $684 72%
Cigna $115 - $1,369 85%
Quick Trip $124 - $916 91%
American Health $132 97%
Healthspring $134 99%
Humana $137 101%
Phcs $144 - $1,084 106%
Healthsmart $155 - $1,222 114%
Multiplan $180 - $1,266 133%
Galaxy $182 - $1,280 134%
Usa $182 - $1,280 134%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3150 Horizon Road, Rockwall, TX 75032
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals